Imperial College London
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Professor Konstantinos Dimopoulos

Faculty of Medicine, National Heart & Lung Institute

Professor of Practice (Adult Congenital Heart Disease)
 
 
 
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Contact

 

+44 (0)20 7352 8121 ext 82771k.dimopoulos02

 
 
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Location

 

Chelsea WingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Surkova:2024:ehjci/jead173,
author = {Surkova, E and Constantine, A and Xu, Z and Segura, de la Cal T and Bispo, D and West, C and Senior, R and Dimopoulos, K and Li, W},
doi = {ehjci/jead173},
journal = {European Heart Journal - Cardiovascular Imaging},
pages = {58--65},
title = {Prognostic significance of subpulmonary left ventricular size and function in patients with a systemic right ventricle},
url = {http://dx.doi.org/10.1093/ehjci/jead173},
volume = {25},
year = {2024}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AimTo assess the additional prognostic significance of echocardiographic parameters of subpulmonary left ventricular (LV) size and function in patients with a systemic right ventricle (SRV).Methods and ResultsAll adults with a SRV who underwent transthoracic echocardiography in 2010-2018 at a large tertiary center were identified. Biventricular size and function were assessed at the most recent exam. The study endpoint was all-cause mortality or heart/heart-lung transplantation.We included 180 patients, 100(55.6%) male, mean age 42.4±12.3 years, of whom 103(57.2%) had undergone Mustard/Senning operations and 77(42.8%) had congenitally corrected transposition of great arteries.Over 4.9[3.8-5.7] years, 28(15.6%) patients died and 4(2.2%) underwent heart or heart-lung transplantation. Univariable predictors of the study endpoint included age, NYHA functional class III or IV, history of atrial arrhythmias, presence of pacemaker or cardioverter-defibrillator, high BNP, and echocardiographic markers of SRV and subpulmonary LV size and function. On multivariable Cox analysis of echocardiographic variables, indexed LV end-systolic diameter (ESDi; HR 2.77 [95%CI 1.35-5.68], p=0.01), LV fractional area change (FAC; HR 0.7 [95%CI 0.57-0.85], p=0.002), SRV basal diameter (HR 1.66 [95%CI 1.21-2.29], p=0.005), and SRV FAC (HR 0.65 [95%CI 0.49-0.87], p=0.008) remained predictive of mortality or transplantation. On ROC analysis, subpulmonary LV parameters performed better than SRV markers in predicting adverse events.ConclusionsSRV basal diameter, SRV FAC, LV ESDi, and LV FAC are significantly and independently associated with mortality and transplantation in adults with a SRV. Accurate echocardiographic assessment of both SRV and subpulmonary LV is therefore essential to inform risk stratification and management.
AU  - Surkova,E
AU  - Constantine,A
AU  - Xu,Z
AU  - Segura,de la Cal T
AU  - Bispo,D
AU  - West,C
AU  - Senior,R
AU  - Dimopoulos,K
AU  - Li,W
DO  - ehjci/jead173
EP  - 65
PY  - 2024///
SN  - 2047-2404
SP  - 58
TI  - Prognostic significance of subpulmonary left ventricular size and function in patients with a systemic right ventricle
T2  - European Heart Journal - Cardiovascular Imaging
UR  - http://dx.doi.org/10.1093/ehjci/jead173
UR  - https://academic.oup.com/ehjcimaging/advance-article/doi/10.1093/ehjci/jead173/7224787
UR  - http://hdl.handle.net/10044/1/105518
VL  - 25
ER  -
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